Provider Demographics
NPI:1235117250
Name:SNOWMAN, BRENDA A (MD)
Entity Type:Individual
Prefix:DR
First Name:BRENDA
Middle Name:A
Last Name:SNOWMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2550 BUSINESS PARK DR NE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37311-6503
Mailing Address - Country:US
Mailing Address - Phone:423-339-8881
Mailing Address - Fax:423-464-6126
Practice Address - Street 1:2550 BUSINESS PARK DR NE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37311-6503
Practice Address - Country:US
Practice Address - Phone:423-339-8881
Practice Address - Fax:423-464-6126
Is Sole Proprietor?:No
Enumeration Date:2006-01-09
Last Update Date:2015-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD023514207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0157720OtherBLUE CROSS BLUE SHIELD
TNQ011934Medicaid
TNQ011934Medicaid